Surgery for Acne Scars At A Glance
- Best Results1-4 sessions
- Treatment Recovery5 days
- Procedure Time5 to 30 mins10-60 min
- Skin SpecialistDavin Lim, Dermatologist
- Duration of ResultsLife (if acne controlled)
- Back to Work2-5 days
- Cost$$ Partial Medicare rebate in most cases
Surgery for acne scars
Subcision & surgery is important to master & apply if & when required. Simple excision can improve & remove certain types of acne scars. Surgical procedures include punch excision, punch elevation, surgical excision, surgical scar elevation, complex surgery & subcision methods.
FactsFacts on Surgery for Acne Scars
- Deep scars are best treated with surgery
- Scar patterns include ice picks, linear, broad atrophic scars
- Punch excision is the most common surgical procedure
- Punch & surgical elevation are required for depressed scars
- Simple excision for linear scars in suitable locations
- Surgical subcision is covered on this website
- Surgical skill sets are a must when treating acne scars
Why is surgical expertise required in the management of acne scars?
Deep scars are out of reach with lasers, microneedling, RFM & even deep chemical peels. These scars require surgical procedures to remove them entirely. Surgery is called on for specific scar types.
When is surgery required to treat scars?
This method is employed when scars lend themselves to surgical intervention. As a guide the following acne scar patterns are best treated with surgical techniques-
- Deep ice pick & pick scars: Excision, punch excision
- Linear scars: Simple closure
- Geographical scars: Surgical design & complex closure
- Bridging scars: Excision
- Depressed demarcated scars, broad base: Surgical elevation
- Smaller depressed scars (2-7 mm): Punch excision
- Attached & fibrotic scars: Surgical subcision
What types of acne scars are treated with surgery?
Classic scars include ice pick & linear scars orientated in RST (relaxed skin tension lines).
Other variants include broad based scars, & bridging acne scars.
What is punch & surgical excision?
Punches are employed for deep & narrow ice picks. This special tool is like a cookie cutter. Punches come in 1,2,3,4,5,6,7 mm sizes. I pick a size depending on the width & angle of the ice pick. This technique is a surgical method to remove the scar in total. It requires a suture that remains for 5-6 days.
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When do I use surgical elevation techniques?
This special technique is employed to treat broad based acne scars, or sharply demarcated depressed scars. This scar pattern is very rare, however I do employ elevation procedures when called for.
Can other procedures be performed at the same time?
I often combine many techniques to treat acne scars on the same day of surgery. Combinations include lasers, peels, microneedling, RFM, & surgical methods as described. Scars are treated according to their morphology. Remember it is the method or revision that gives the biggest improvement, & not the piece of equipment.
How many treatments will I require?
It depends on the extent of scarring. In isolated cases, only one session is required. Some patients have hundreds of deep ice pick scars. In these cases 3-5 sessions are required over a period of 4 to 10 months.
What are the risks of surgery?
Surgical procedures, along with lasers & peels carry risks.
- Spread scars- 4% of cases. Due to lack of collagen surrounding the scars.
- Infection – 3%.
- Skin colour changes 3%.
- Hypertrophic or keloid scars- 2%
How long is the recovery following acne scar surgery?
Sutures or surgical strips are in place for 4-7 days. During this time you must limit your activities. It often takes 3-6 months or even longer for scars to remodel after surgery.
What is the cost of surgery for acne scars?
Cost will depend on the extent & complexity of closure. All skin surgery is performed by myself.
Medicare Australia provides rebates for scar revision under the care of Specialist dermatologists or plastic surgeons, however according to the Medicare director ‘severe scars must compromise activities of daily living including eating, drinking & speech.’
Davin’s Viewpoint on Surgical Techniques for Acne Scars
Surgery is important to master in the management of acne scars. Linear, ice pick, pick, geometrical, & broad based depressed scars can be effectively treated with surgery. In some cases, surgery is not only an option, it is the treatment of choice.
Most of my revision procedures are based upon treating scar patterns with methods. Scar revision at a specialist level is never about the piece of equipment, it is about applying methods to cases. In some cases it is surgical, in others, peels, lasers & devices maybe appropriate.
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